关键词: 内皮细胞损伤标记物  循环内皮细胞 , 血管炎 抗中性粒细胞胞质抗体

Abstract:

Objective：To detect various endothelial markers of circulating endothelial cells(CECs), soluble thrombomodulin(sTM), von Willebrand factor(vWF), E-selectin and Vascular cell adhesion molecule 1(VCAM-1) in patients with active and remission stage of ANCA associated vasculitis, and to explore the relationship between endothelial markers and the activity of ANCA associated vasulitis (AAV). Methodology: Fifty six patients with AAV in active phase (M:23, F:33, mean age 48.1± 16.8y, BVAS score 13.6± 2.4), 28 patients in remission phase (M:9, F:19, mean age 50.2± 16.4y, BVAS score 0), and 20 healthy controls were enrolled in this study. The CECs were isolated from peripheral blood by use of Dynabeads coated with antibodies against CD146,and the plasma sTM, vWF, E-selectin and ignificance of VCAM-1 were detected with ELISA. Results: CECs, vWF, E-selectin and sTM levels, but not VCAM-1, were higher in the active phase of AAV than that in controls (P<0.01), no significant differences of endothelial markers were found between AAV patients in remission and controls. The CECs (30±1 vs 17±5.0 cells/ml, P<0.01) and levels of plasma sTM (9.5±6.8vs 6.1±3.4 ng/ml，P<0.01) were significant increased in active AAV patients than that in remission, whereas corrected for renal function, sTM did not significant, and plasma vWF and E-selectin levels showed no significant differences between patients in active phase and in remission patients. The sTM level in the active phase was positive related with serum creatinine and urine protein, while elevated sTM levels were associated with higher serum creatinine levels. The endothelial markers had no relation with crescents and fibrinoid necrotic lesion.  Conclusion: Circulating endothelial cells is potential biomarker in evaluating the activity of ANCA associated vasulitis.